1
VATI NURSING CARE OF CHILDREN ASSESSMENT EXAM
2026/2027 | Pediatric NCLEX-RN Mastery | Grade A Verified
Solutions | Score an A | Pass Guaranteed
Section 1: Growth & Developmental Milestones (Q1-18)
Q1. A nurse is assessing a 6-month-old infant during a well-child visit. According to
Erikson's psychosocial development theory, which developmental crisis is this infant
resolving, and what nursing intervention best supports healthy resolution?
A. Autonomy vs. shame and doubt; encourage independent feeding
B. Trust vs. mistrust; respond consistently to the infant's needs and maintain caregiver
presence
C. Initiative vs. guilt; provide opportunities for exploration
D. Industry vs. inferiority; praise accomplishments
B. Trust vs. mistrust; respond consistently to the infant's needs and maintain
caregiver presence [CORRECT]
Rationale: Erikson's first stage (birth to 18 months) is trust vs. mistrust. Infants
develop trust when caregivers respond predictably to their needs (feeding, comfort,
hygiene). Consistent, loving care establishes a foundation for future relationships. The
distractor "autonomy vs. shame and doubt" applies to toddlers (18 months-3 years),
where independence is fostered. Applying toddler-stage interventions to an infant is
developmentally inappropriate and reflects a common NCLEX trap of confusing age-
appropriate stages.
Correct Answer: B
Q2. A nurse is caring for a hospitalized 2-year-old toddler. The child becomes distressed
when the mother leaves the room and clings to her when she returns. According to
developmental theory, which behavior is the toddler demonstrating, and what is the
most appropriate nursing intervention?
,2
A. Separation anxiety; encourage the mother to stay continuously and avoid leaving
B. Autonomy vs. shame and doubt; provide choices within limits and maintain routines
C. Initiative vs. guilt; redirect with play therapy
D. Industry vs. inferiority; assign the child simple tasks
B. Autonomy vs. shame and doubt; provide choices within limits and maintain
routines [CORRECT]
Rationale: Toddlers (1-3 years) are in Erikson's autonomy vs. shame and doubt stage,
striving for independence while experiencing separation anxiety. Providing choices
("Do you want the red cup or blue cup?") supports autonomy while maintaining
routines reduces anxiety. The distractor suggesting the mother never leave is unrealistic
and promotes unhealthy dependency; gradual separation with transitional objects is
preferred. Confusing toddler behaviors with preschool initiative (ages 3-6) is a common
NCLEX error.
Correct Answer: B
Q3. A nurse is evaluating a 4-month-old infant during a routine assessment. Which
developmental milestone would the nurse expect to observe, and which finding would
be considered a red flag requiring referral?
A. Rolling from back to front; not smiling responsively by 4 months
B. Sitting without support; not reaching for objects
C. Walking with support; not babbling
D. Using pincer grasp; not laughing
A. Rolling from back to front; not smiling responsively by 4 months [CORRECT]
Rationale: By 4 months, infants typically roll from back to front, laugh, bring hands to
midline, and smile responsively (social smile established by 2 months). Failure to smile
responsively by 4 months is a red flag for developmental delay, autism spectrum
concern, or visual impairment. The distractor "sitting without support" is a 6-month
milestone, not 4 months—a classic NCLEX trap of advancing milestones prematurely.
The Denver II screening tool identifies social smile as a critical early milestone.
Correct Answer: A
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Q4. A nurse is caring for a hospitalized 3-year-old preschooler who believes that
wearing a hospital gown makes them "sick" and that changing clothes will make them
"better." According to Piaget's cognitive development theory, which stage and
characteristic explains this thinking?
A. Sensorimotor stage; object permanence
B. Preoperational stage; magical thinking and transductive reasoning
C. Concrete operational stage; logical reasoning
D. Formal operational stage; abstract thinking
B. Preoperational stage; magical thinking and transductive reasoning [CORRECT]
Rationale: Preschoolers (2-7 years) are in Piaget's preoperational stage, characterized
by magical thinking (believing thoughts/wishes cause events) and transductive
reasoning (assuming causation between unrelated events, e.g., "I wore this gown, so I'm
sick"). This explains why preschoolers may blame themselves for illness. The distractor
"concrete operational" (ages 7-11) involves logical reasoning about concrete events—
applying this to a 3-year-old is developmentally inappropriate and reflects the common
NCLEX error of using adult cognitive frameworks for children.
Correct Answer: B
Q5. A nurse is assessing a 9-month-old infant. Which gross motor milestone is expected
at this age, and which fine motor skill should also be present?
A. Walking independently; pincer grasp
B. Sitting without support; raking grasp transferring objects hand-to-hand
C. Cruising along furniture; mature pincer grasp
D. Running; building tower of 2 blocks
B. Sitting without support; raking grasp transferring objects hand-to-hand
[CORRECT]
Rationale: By 9 months, infants typically sit without support, crawl, pull to stand, and
use a raking grasp (using fingers against palm) while transferring objects between
, 4
hands. The pincer grasp (thumb and forefinger) matures around 10-12 months. The
distractor "walking independently" is a 12-15 month milestone, and "mature pincer
grasp" is 12 months—both represent premature advancement. Confusing 9-month with
12-month milestones is a frequent NCLEX error that can lead to unnecessary
developmental referrals or missed delays.
Correct Answer: B
Q6. A nurse is preparing a 5-year-old for surgery. The child asks, "Will the doctor cut me
open with a knife?" According to developmental stage, which response is most
appropriate?
A. "Don't worry, you won't feel anything because you'll be asleep."
B. "The doctor will use special tools to fix the inside part that needs help. You'll be
sleeping so you won't feel it, and I'll be here when you wake up."
C. "That's a silly question. The doctor knows what he's doing."
D. "Yes, but it's a very sharp knife and it will hurt a lot."
B. "The doctor will use special tools to fix the inside part that needs help. You'll be
sleeping so you won't feel it, and I'll be here when you wake up." [CORRECT]
Rationale: Preschoolers (3-6 years) in the initiative vs. guilt stage need honest, simple
explanations without frightening details. They fear bodily injury and mutilation. Option
B provides age-appropriate truth while offering reassurance and presence. Option A is
too vague and may increase anxiety; Option C dismisses the child's legitimate fear,
promoting guilt; Option D is terrifying and developmentally traumatic. The common
NCLEX trap is providing either too much detail (causing fear) or dismissive reassurance
(invalidating the child's concerns).
Correct Answer: B
Q7. A nurse is caring for a hospitalized 8-year-old with a fractured femur. The child asks
detailed questions about the x-ray machine and how bones heal. According to Piaget,
VATI NURSING CARE OF CHILDREN ASSESSMENT EXAM
2026/2027 | Pediatric NCLEX-RN Mastery | Grade A Verified
Solutions | Score an A | Pass Guaranteed
Section 1: Growth & Developmental Milestones (Q1-18)
Q1. A nurse is assessing a 6-month-old infant during a well-child visit. According to
Erikson's psychosocial development theory, which developmental crisis is this infant
resolving, and what nursing intervention best supports healthy resolution?
A. Autonomy vs. shame and doubt; encourage independent feeding
B. Trust vs. mistrust; respond consistently to the infant's needs and maintain caregiver
presence
C. Initiative vs. guilt; provide opportunities for exploration
D. Industry vs. inferiority; praise accomplishments
B. Trust vs. mistrust; respond consistently to the infant's needs and maintain
caregiver presence [CORRECT]
Rationale: Erikson's first stage (birth to 18 months) is trust vs. mistrust. Infants
develop trust when caregivers respond predictably to their needs (feeding, comfort,
hygiene). Consistent, loving care establishes a foundation for future relationships. The
distractor "autonomy vs. shame and doubt" applies to toddlers (18 months-3 years),
where independence is fostered. Applying toddler-stage interventions to an infant is
developmentally inappropriate and reflects a common NCLEX trap of confusing age-
appropriate stages.
Correct Answer: B
Q2. A nurse is caring for a hospitalized 2-year-old toddler. The child becomes distressed
when the mother leaves the room and clings to her when she returns. According to
developmental theory, which behavior is the toddler demonstrating, and what is the
most appropriate nursing intervention?
,2
A. Separation anxiety; encourage the mother to stay continuously and avoid leaving
B. Autonomy vs. shame and doubt; provide choices within limits and maintain routines
C. Initiative vs. guilt; redirect with play therapy
D. Industry vs. inferiority; assign the child simple tasks
B. Autonomy vs. shame and doubt; provide choices within limits and maintain
routines [CORRECT]
Rationale: Toddlers (1-3 years) are in Erikson's autonomy vs. shame and doubt stage,
striving for independence while experiencing separation anxiety. Providing choices
("Do you want the red cup or blue cup?") supports autonomy while maintaining
routines reduces anxiety. The distractor suggesting the mother never leave is unrealistic
and promotes unhealthy dependency; gradual separation with transitional objects is
preferred. Confusing toddler behaviors with preschool initiative (ages 3-6) is a common
NCLEX error.
Correct Answer: B
Q3. A nurse is evaluating a 4-month-old infant during a routine assessment. Which
developmental milestone would the nurse expect to observe, and which finding would
be considered a red flag requiring referral?
A. Rolling from back to front; not smiling responsively by 4 months
B. Sitting without support; not reaching for objects
C. Walking with support; not babbling
D. Using pincer grasp; not laughing
A. Rolling from back to front; not smiling responsively by 4 months [CORRECT]
Rationale: By 4 months, infants typically roll from back to front, laugh, bring hands to
midline, and smile responsively (social smile established by 2 months). Failure to smile
responsively by 4 months is a red flag for developmental delay, autism spectrum
concern, or visual impairment. The distractor "sitting without support" is a 6-month
milestone, not 4 months—a classic NCLEX trap of advancing milestones prematurely.
The Denver II screening tool identifies social smile as a critical early milestone.
Correct Answer: A
,3
Q4. A nurse is caring for a hospitalized 3-year-old preschooler who believes that
wearing a hospital gown makes them "sick" and that changing clothes will make them
"better." According to Piaget's cognitive development theory, which stage and
characteristic explains this thinking?
A. Sensorimotor stage; object permanence
B. Preoperational stage; magical thinking and transductive reasoning
C. Concrete operational stage; logical reasoning
D. Formal operational stage; abstract thinking
B. Preoperational stage; magical thinking and transductive reasoning [CORRECT]
Rationale: Preschoolers (2-7 years) are in Piaget's preoperational stage, characterized
by magical thinking (believing thoughts/wishes cause events) and transductive
reasoning (assuming causation between unrelated events, e.g., "I wore this gown, so I'm
sick"). This explains why preschoolers may blame themselves for illness. The distractor
"concrete operational" (ages 7-11) involves logical reasoning about concrete events—
applying this to a 3-year-old is developmentally inappropriate and reflects the common
NCLEX error of using adult cognitive frameworks for children.
Correct Answer: B
Q5. A nurse is assessing a 9-month-old infant. Which gross motor milestone is expected
at this age, and which fine motor skill should also be present?
A. Walking independently; pincer grasp
B. Sitting without support; raking grasp transferring objects hand-to-hand
C. Cruising along furniture; mature pincer grasp
D. Running; building tower of 2 blocks
B. Sitting without support; raking grasp transferring objects hand-to-hand
[CORRECT]
Rationale: By 9 months, infants typically sit without support, crawl, pull to stand, and
use a raking grasp (using fingers against palm) while transferring objects between
, 4
hands. The pincer grasp (thumb and forefinger) matures around 10-12 months. The
distractor "walking independently" is a 12-15 month milestone, and "mature pincer
grasp" is 12 months—both represent premature advancement. Confusing 9-month with
12-month milestones is a frequent NCLEX error that can lead to unnecessary
developmental referrals or missed delays.
Correct Answer: B
Q6. A nurse is preparing a 5-year-old for surgery. The child asks, "Will the doctor cut me
open with a knife?" According to developmental stage, which response is most
appropriate?
A. "Don't worry, you won't feel anything because you'll be asleep."
B. "The doctor will use special tools to fix the inside part that needs help. You'll be
sleeping so you won't feel it, and I'll be here when you wake up."
C. "That's a silly question. The doctor knows what he's doing."
D. "Yes, but it's a very sharp knife and it will hurt a lot."
B. "The doctor will use special tools to fix the inside part that needs help. You'll be
sleeping so you won't feel it, and I'll be here when you wake up." [CORRECT]
Rationale: Preschoolers (3-6 years) in the initiative vs. guilt stage need honest, simple
explanations without frightening details. They fear bodily injury and mutilation. Option
B provides age-appropriate truth while offering reassurance and presence. Option A is
too vague and may increase anxiety; Option C dismisses the child's legitimate fear,
promoting guilt; Option D is terrifying and developmentally traumatic. The common
NCLEX trap is providing either too much detail (causing fear) or dismissive reassurance
(invalidating the child's concerns).
Correct Answer: B
Q7. A nurse is caring for a hospitalized 8-year-old with a fractured femur. The child asks
detailed questions about the x-ray machine and how bones heal. According to Piaget,
